Labyrinthine fistula as a complication of cholesteatoma.
Labyrinthine fistula as a complication of cholesteatoma.
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发表时间：
1997-11
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通讯作者：
G. Magliulo;G. Terranova;S. Varacalli;C. Sepe
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作者：
G. Magliulo;G. Terranova;S. Varacalli;C. Sepe
假设 本研究的目的是介绍作者在治疗胆脂瘤引起的迷路瘘方面的经验。方法回顾性分析1979年至1975年因胆脂瘤并发迷路瘘而接受手术治疗的92例患者的临床资料。在此期间，有 1,205 名患者因胆脂瘤接受了手术。在手术期间对每位患者的瘘管部位和大小进行评估，并比较手术前后的听力阈值。结果71例患者瘘管累及外半规管。在九名患者中观察到多个瘘管。 83.7% 的患者术后听力水平没有变化或有所改善。当发现较小尺寸的瘘管时，听力结果和瘘管大小之间的比较显示出更好的结果。未检测到开放式和封闭式技术之间存在显着差异。通过手术封闭中断迷路治疗的患者获得了良好的结果。结论 目前的研究证实，为了保护这些患者的听力功能，必须仔细操作迷路瘘管。根据作者的经验，与先前倾向于中断和随后闭塞半规管的方法相比，瘘管治疗的未来趋势可能会转向不太保守的技术。
HYPOTHESIS The objective of this study was to present the authors' experience in the management of labyrinthine fistula caused by cholesteatoma. METHODS The clinical charts of 92 patients who underwent surgical procedures for cholesteatoma complicated by labyrinthine fistula between 1979 and 1975 were reviewed retrospectively. In this period, 1,205 patients were operated on for cholesteatoma. In each patient, the site and size of the fistula were evaluated during surgery and the hearing thresholds were compared before and after surgery. RESULTS The fistula involved the lateral semicircular canal in 71 patients. Multiple fistulas were observed in nine patients. Postoperative hearing levels were unchanged or improved in 83.7% of patients. Comparison between hearing outcomes and size of the fistula showed better findings when smaller size fistulas were found. No significant differences between open and closed techniques were detected. Favorable outcomes were obtained in patients treated with surgical obliteration of the interrupted labyrinth. CONCLUSIONS The current study confirmed that careful manipulation of the labyrinthine fistula is mandatory to preserve hearing functions for these patients. According to the authors' experience, the future trend for fistula treatment could be directed toward less conservative techniques compared with the previous indications favoring methods of interruption and subsequent obliteration of the semicircular canals.